Treatment of a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia by 3D printed guide plate-assisted hematoma puncture and catheter drainage / 中国基层医药

ABSTRACT

Objective:To investigate the clinical efficacy of 3D printed guide plate-assisted hematoma puncture and catheter drainage in the treatment of a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia.Methods:The clinical data of 42 patients with a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia who received treatment with 3D printed guide plate-assisted hematoma puncture and catheter drainage in Dazhu Hospital of North Sichuan Medical College from January 2016 to January 2021 were retrospectively analyzed. In the traditional puncture group, there were 19 patients who received traditional punctures according to preoperative cranial CT findings (traditional puncture group). In the 3D printed guide plate puncture group, there were 23 patients who received hematoma puncture and catheter drainage assisted by a 3D printed guide plate. Preoperative preparation time (from admission to operation), operative time, the number of hematoma punctures, hematoma clearance rate, postoperative indwelling time of drainage tube, residual hematoma rate, the occurrence of puncture canal bleeding, intracranial infection, Glasgow Coma Scale score measured at 3 and 7 days after surgery, and Glasgow Outcome Scale score measured at 1, 3 and 6 months after surgery were compared between the two groups.Results:There were no significant differences in preoperative preparation time and operative time between the two groups ( t = 0.25, 0.40, both P > 0.05). 3D-printed guide plate-assisted hematoma puncture reduced the probability of reveiving one more hematoma puncture during the surgery. There was no significant difference in the number of hematoma puncture between the two groups ( χ2= 0.48, P > 0.05). There were no significant differences in the probabilities of puncture canal bleeding and intracranial infection between the two groups ( χ2 = 0.05, 0.03, both P > 0.05). Postoperative indwelling time of the drainage tube in the 3D printed guide plate puncture group was significantly shorter than that in the traditional puncture group [(3.10 ± 0.38) vs. (3.46 ± 0.52) days, t = 2.65, P < 0.05]. The residual hematoma rate in the 3D printed guide plate puncture group was significantly lower than that in the traditional puncture group [(32.04 ± 5.33)% vs. (37.37 ± 5.51)%, χ2 = 3.20, P < 0.05]. There were significant differences in Glasgow Coma Scale score measured at 3 and 7 days after surgery between the two groups [(12.04 ± 1.19) points vs. (11.26 ± 0.93) points, (13.65 ± 0.88) points vs. (12.94 ± 0.97) points, t = 2.33, 2.46, both P < 0.05]. Glasgow Outcome Scale score measured at 1, 3, and 6 months after surgery in the 3D printed guide plate puncture group was 18, 21, and 22 points, respectively, which was significantly higher than 9, 11, and 12 points in the traditional puncture group ( χ2 = 4.34, 4.69, 5.17, all P < 0.05). Conclusion:3D printed guide plate assisted hematoma puncture and catheter drainage for treatment of a moderate volume of hypertensive intracerebral hemorrhage in the basal ganglia can increase the accuracy of puncture, decrease hematoma residual rate, improve short- and long-term prognosis, does not prolong preoperative preparation time. Moreover, it costs low, is safe, and is easy to learn.